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HESI RN Comprehensive Exit Exam
2025 – Actual Test Bank with 200 Verified
Questions, Rationalized Answers &
Expert Review | 100% Pass Guarantee
Question 1
A nurse is caring for a client with a new diagnosis of heart failure. Which assessment finding
requires immediate intervention?
A. Blood pressure of 140/90 mm Hg
B. Crackles in bilateral lung bases
C. Heart rate of 88 beats/min
D. Peripheral edema in lower extremities
Correct Answer: B. Crackles in bilateral lung bases
Rationale: Crackles in the lung bases indicate pulmonary edema, a life-threatening complication
of heart failure due to fluid overload. This requires immediate intervention to prevent respiratory
distress, per HESI RN standards for prioritizing acute conditions.
Question 2
A client with type 1 diabetes mellitus reports nausea and vomiting. The nurse notes a blood
glucose level of 350 mg/dL. What is the priority action?
A. Administer insulin as prescribed
B. Provide oral glucose tablets
C. Encourage clear liquids
D. Check urine for ketones
Correct Answer: D. Check urine for ketones
Rationale: Nausea, vomiting, and elevated blood glucose suggest possible diabetic ketoacidosis
(DKA). Checking for ketones is the priority to confirm DKA, which requires urgent treatment,
per HESI RN critical care guidelines.
Question 3
, 2
A nurse is preparing to administer enalapril to a client with hypertension. Which assessment is
most important before giving the medication?
A. Apical pulse
B. Blood pressure
C. Respiratory rate
D. Temperature
Correct Answer: B. Blood pressure
Rationale: Enalapril, an ACE inhibitor, lowers blood pressure. Assessing blood pressure is
critical to prevent hypotension, especially in clients with hypertension, per HESI RN
pharmacology standards.
Question 4
A client with a history of myocardial infarction is prescribed warfarin. Which laboratory value
should the nurse monitor?
A. Platelet count
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Hemoglobin A1c
Correct Answer: B. International Normalized Ratio (INR)
Rationale: Warfarin’s anticoagulant effect is monitored via INR to ensure therapeutic levels
(typically 2.0–3.0 for most conditions), preventing bleeding or clotting risks, per HESI RN
standards for anticoagulant therapy.
Question 5
A nurse is assessing a client with suspected appendicitis. Which finding is most concerning?
A. Nausea and vomiting
B. Low-grade fever
C. Rebound tenderness in the right lower quadrant
D. Mild abdominal distention
Correct Answer: C. Rebound tenderness in the right lower quadrant
Rationale: Rebound tenderness is a hallmark sign of peritoneal irritation, often indicating
appendicitis or perforation, requiring urgent surgical evaluation, per HESI RN acute care
guidelines.
Question 6
, 3
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via
nasal cannula. The client’s SpO2 is 88%. What is the nurse’s priority action?
A. Increase oxygen to 4 L/min
B. Encourage deep breathing exercises
C. Notify the healthcare provider
D. Position the client upright
Correct Answer: C. Notify the healthcare provider
Rationale: An SpO2 of 88% in a COPD client indicates hypoxemia. Increasing oxygen without
provider guidance may suppress respiratory drive. Notification is the priority, per HESI RN
respiratory care standards.
Question 7
A nurse is teaching a client about self-administration of insulin. Which statement indicates a
need for further teaching?
A. “I will rotate injection sites to prevent tissue damage.”
B. “I will store unopened insulin vials in the refrigerator.”
C. “I can mix my regular and NPH insulin in the same syringe.”
D. “I will inject insulin into my thigh before breakfast.”
Correct Answer: C. “I can mix my regular and NPH insulin in the same syringe.”
Rationale: While regular and NPH insulin can be mixed, the statement lacks detail on the correct
mixing technique (clear-to-cloudy order). This indicates a need for further teaching, per HESI
RN patient education standards.
Question 8
A client with a chest tube reports sudden shortness of breath. The nurse notes continuous
bubbling in the water seal chamber. What is the priority action?
A. Check the chest tube for kinks
B. Assess for a pneumothorax
C. Notify the healthcare provider
D. Increase suction pressure
Correct Answer: C. Notify the healthcare provider
Rationale: Continuous bubbling in the water seal chamber suggests an air leak, potentially
indicating a pneumothorax or system issue. Notifying the provider is the priority for immediate
intervention, per HESI RN critical care standards.
, 4
Question 9
A nurse is caring for a client receiving total parenteral nutrition (TPN). Which assessment
finding requires immediate action?
A. Blood glucose of 180 mg/dL
B. Weight gain of 1 kg in 24 hours
C. Temperature of 100.4°F (38°C)
D. Urine output of 50 mL/hr
Correct Answer: C. Temperature of 100.4°F (38°C)
Rationale: A fever in a client receiving TPN may indicate catheter-related infection, a serious
complication requiring immediate action to prevent sepsis, per HESI RN nutrition standards.
Question 10
A client with preeclampsia at 36 weeks gestation reports a headache and blurred vision. What is
the nurse’s priority action?
A. Administer acetaminophen
B. Assess blood pressure
C. Encourage rest in a dark room
D. Provide oral hydration
Correct Answer: B. Assess blood pressure
Rationale: Headache and blurred vision in preeclampsia suggest worsening condition or possible
eclampsia. Assessing blood pressure is the priority to guide treatment, per HESI RN maternal
health standards.
Question 11
A nurse is caring for a client with a new colostomy. Which statement by the client indicates a
need for further teaching?
A. “I will change the pouch every 5–7 days.”
B. “I will avoid high-fiber foods initially.”
C. “I will irrigate the colostomy daily.”
D. “I will monitor the stoma for pink color.”
Correct Answer: C. “I will irrigate the colostomy daily.”
Rationale: Routine daily irrigation is not necessary for all colostomies and depends on the type
and client needs. This statement indicates a need for clarification, per HESI RN patient education
standards.
HESI RN Comprehensive Exit Exam
2025 – Actual Test Bank with 200 Verified
Questions, Rationalized Answers &
Expert Review | 100% Pass Guarantee
Question 1
A nurse is caring for a client with a new diagnosis of heart failure. Which assessment finding
requires immediate intervention?
A. Blood pressure of 140/90 mm Hg
B. Crackles in bilateral lung bases
C. Heart rate of 88 beats/min
D. Peripheral edema in lower extremities
Correct Answer: B. Crackles in bilateral lung bases
Rationale: Crackles in the lung bases indicate pulmonary edema, a life-threatening complication
of heart failure due to fluid overload. This requires immediate intervention to prevent respiratory
distress, per HESI RN standards for prioritizing acute conditions.
Question 2
A client with type 1 diabetes mellitus reports nausea and vomiting. The nurse notes a blood
glucose level of 350 mg/dL. What is the priority action?
A. Administer insulin as prescribed
B. Provide oral glucose tablets
C. Encourage clear liquids
D. Check urine for ketones
Correct Answer: D. Check urine for ketones
Rationale: Nausea, vomiting, and elevated blood glucose suggest possible diabetic ketoacidosis
(DKA). Checking for ketones is the priority to confirm DKA, which requires urgent treatment,
per HESI RN critical care guidelines.
Question 3
, 2
A nurse is preparing to administer enalapril to a client with hypertension. Which assessment is
most important before giving the medication?
A. Apical pulse
B. Blood pressure
C. Respiratory rate
D. Temperature
Correct Answer: B. Blood pressure
Rationale: Enalapril, an ACE inhibitor, lowers blood pressure. Assessing blood pressure is
critical to prevent hypotension, especially in clients with hypertension, per HESI RN
pharmacology standards.
Question 4
A client with a history of myocardial infarction is prescribed warfarin. Which laboratory value
should the nurse monitor?
A. Platelet count
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Hemoglobin A1c
Correct Answer: B. International Normalized Ratio (INR)
Rationale: Warfarin’s anticoagulant effect is monitored via INR to ensure therapeutic levels
(typically 2.0–3.0 for most conditions), preventing bleeding or clotting risks, per HESI RN
standards for anticoagulant therapy.
Question 5
A nurse is assessing a client with suspected appendicitis. Which finding is most concerning?
A. Nausea and vomiting
B. Low-grade fever
C. Rebound tenderness in the right lower quadrant
D. Mild abdominal distention
Correct Answer: C. Rebound tenderness in the right lower quadrant
Rationale: Rebound tenderness is a hallmark sign of peritoneal irritation, often indicating
appendicitis or perforation, requiring urgent surgical evaluation, per HESI RN acute care
guidelines.
Question 6
, 3
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen at 2 L/min via
nasal cannula. The client’s SpO2 is 88%. What is the nurse’s priority action?
A. Increase oxygen to 4 L/min
B. Encourage deep breathing exercises
C. Notify the healthcare provider
D. Position the client upright
Correct Answer: C. Notify the healthcare provider
Rationale: An SpO2 of 88% in a COPD client indicates hypoxemia. Increasing oxygen without
provider guidance may suppress respiratory drive. Notification is the priority, per HESI RN
respiratory care standards.
Question 7
A nurse is teaching a client about self-administration of insulin. Which statement indicates a
need for further teaching?
A. “I will rotate injection sites to prevent tissue damage.”
B. “I will store unopened insulin vials in the refrigerator.”
C. “I can mix my regular and NPH insulin in the same syringe.”
D. “I will inject insulin into my thigh before breakfast.”
Correct Answer: C. “I can mix my regular and NPH insulin in the same syringe.”
Rationale: While regular and NPH insulin can be mixed, the statement lacks detail on the correct
mixing technique (clear-to-cloudy order). This indicates a need for further teaching, per HESI
RN patient education standards.
Question 8
A client with a chest tube reports sudden shortness of breath. The nurse notes continuous
bubbling in the water seal chamber. What is the priority action?
A. Check the chest tube for kinks
B. Assess for a pneumothorax
C. Notify the healthcare provider
D. Increase suction pressure
Correct Answer: C. Notify the healthcare provider
Rationale: Continuous bubbling in the water seal chamber suggests an air leak, potentially
indicating a pneumothorax or system issue. Notifying the provider is the priority for immediate
intervention, per HESI RN critical care standards.
, 4
Question 9
A nurse is caring for a client receiving total parenteral nutrition (TPN). Which assessment
finding requires immediate action?
A. Blood glucose of 180 mg/dL
B. Weight gain of 1 kg in 24 hours
C. Temperature of 100.4°F (38°C)
D. Urine output of 50 mL/hr
Correct Answer: C. Temperature of 100.4°F (38°C)
Rationale: A fever in a client receiving TPN may indicate catheter-related infection, a serious
complication requiring immediate action to prevent sepsis, per HESI RN nutrition standards.
Question 10
A client with preeclampsia at 36 weeks gestation reports a headache and blurred vision. What is
the nurse’s priority action?
A. Administer acetaminophen
B. Assess blood pressure
C. Encourage rest in a dark room
D. Provide oral hydration
Correct Answer: B. Assess blood pressure
Rationale: Headache and blurred vision in preeclampsia suggest worsening condition or possible
eclampsia. Assessing blood pressure is the priority to guide treatment, per HESI RN maternal
health standards.
Question 11
A nurse is caring for a client with a new colostomy. Which statement by the client indicates a
need for further teaching?
A. “I will change the pouch every 5–7 days.”
B. “I will avoid high-fiber foods initially.”
C. “I will irrigate the colostomy daily.”
D. “I will monitor the stoma for pink color.”
Correct Answer: C. “I will irrigate the colostomy daily.”
Rationale: Routine daily irrigation is not necessary for all colostomies and depends on the type
and client needs. This statement indicates a need for clarification, per HESI RN patient education
standards.
